A randomized trial comparing two low-intensity psychological interventions for distressed patients with cancer and their caregivers

Kathleen, Suzanne, Girgis, Araf, Occhipinti, Stefano, Hutchison, Sandy, Turner, Jane, McDowell, Michelle, Mihalopoulos, Cathrine, Carter, Robert and Dunn, Jeffrey Charles (2014) A randomized trial comparing two low-intensity psychological interventions for distressed patients with cancer and their caregivers. Oncology Nursing Forum, 41 4: E256-E266. doi:10.1188/14.ONF.E256-E266


Author Kathleen, Suzanne
Girgis, Araf
Occhipinti, Stefano
Hutchison, Sandy
Turner, Jane
McDowell, Michelle
Mihalopoulos, Cathrine
Carter, Robert
Dunn, Jeffrey Charles
Title A randomized trial comparing two low-intensity psychological interventions for distressed patients with cancer and their caregivers
Journal name Oncology Nursing Forum   Check publisher's open access policy
ISSN 1538-0688
0190-535X
Publication date 2014-07-01
Year available 2014
Sub-type Article (original research)
DOI 10.1188/14.ONF.E256-E266
Open Access Status DOI
Volume 41
Issue 4
Start page E256
End page E266
Total pages 11
Place of publication Pittsburgh, PA, United States
Publisher Oncology Nursing Society
Language eng
Subject 2917 Oncology (nursing)
Abstract Purpose/Objectives: To compare the effectiveness of two low-intensity approaches for distressed patients with cancer and caregivers who had called cancer helplines seeking support. Baseline distress was hypothesized as a moderator of intervention effect. Design: Randomized trial. Setting: Community-based cancer helplines in Queensland and New South Wales, Australia. Sample: 354 patients with cancer and 336 caregivers. Methods: Participants were randomized to either a single session of nurse-led self-management intervention or a five-session psychologist cognitive behavioral intervention delivered by telephone. Assessments were undertaken at baseline (preintervention) and at 3, 6, and 12 months. Main Research Variables: Psychological and cancer-specific distress and post-traumatic growth. Findings: No significant moderation by baseline cancer-specific distress was noted. For low-education patients, only the psychologist intervention was associated with a significant drop in distress. For all other participants, distress decreased over time in both arms with small to large effect sizes (Cohen's ds = 0.05-0.82). Post-traumatic growth increased over time for all participants (Cohen's ds = 0.6-0.64). Conclusions: Many distressed patients with cancer and their caregivers may benefit significantly from a single session of a nurse psychoeducation intervention that can be delivered remotely by telephone and supported by self-management materials. Research is needed to develop an algorithm that moves beyond the use of distress as the only indicator for referral to specialist psychological services. Survivors and caregivers with low education and low literacy may require more in-depth and targeted support. Implications for Nursing: Brief nurse psychoeducation and stress management for cancer survivors and caregivers should be considered as part of a tiered approach to psychosocial care.
Formatted abstract
Purpose/Objectives: To compare the effectiveness of two low-intensity approaches for distressed patients with cancer and caregivers who had called cancer helplines seeking support. Baseline distress was hypothesized as a moderator of intervention effect.

Design: Randomized trial.

Setting: Community-based cancer helplines in Queensland and New South Wales, Australia.

Sample: 354 patients with cancer and 336 caregivers.

Methods: Participants were randomized to either a single session of nurse-led self-management intervention or a five-session psychologist cognitive behavioral intervention delivered by telephone. Assessments were undertaken at baseline (preintervention) and at 3, 6, and 12 months.

Main Research Variables: Psychological and cancer-specific distress and post-traumatic growth.

Findings: No significant moderation by baseline cancer-specific distress was noted. For low-education patients, only the psychologist intervention was associated with a significant drop in distress. For all other participants, distress decreased over time in both arms with small to large effect sizes (Cohen's ds = 0.05-0.82). Post-traumatic growth increased over time for all participants (Cohen's ds = 0.6-0.64).

Conclusions: Many distressed patients with cancer and their caregivers may benefit significantly from a single session of a nurse psychoeducation intervention that can be delivered remotely by telephone and supported by self-management materials. Research is needed to develop an algorithm that moves beyond the use of distress as the only indicator for referral to specialist psychological services. Survivors and caregivers with low education and low literacy may require more in-depth and targeted support.

Implications for Nursing: Brief nurse psychoeducation and stress management for cancer survivors and caregivers should be considered as part of a tiered approach to psychosocial care.
Keyword Cancer
Psychological intervention
Nursing practice
Low intensity
Caregivers
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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